title: Fatal extensive bone cement embolism: histological findings confirmed by Fourier transform infrared spectroscopy.
abstract: We herein report the first case of fatal extensive bone cement embolism appearing in pulmonary arterioles following surgical vertebral screw augmentation, which histological evidence of bone cement emboli was confirmed by Fourier transform infrared spectroscopy. A 47-year-old woman has accepted multilevel spine fusion and pedicle screw augmentation with totally 4 ml bone cement infusion. She suddenly developed low blood pressure, dyspnoea, and unconsciousness approximately 1 h post anaesthetic recovery, and then she was dead. It was shown both lungs were edematous in autopsy, and bluish emboli were appeared in extensive pulmonary arterioles in H&E stained sections. Negative information was shown in Molybdenum target X-ray imaging, but the emboli were confirmed to be PMMA bone cement by Fourier transform infrared spectroscopy. The present case indicated it might be effective to confirm the dubious trace component in histology by FTIR.
authors.affiliation: Key Laboratory of Evidence Science(China University of Political Science and Law), Ministry of Education, Beijing, PR China.
authors.forename: Na
authors.initials: N
authors.lastname: Zheng
authors.forename: Man
authors.initials: M
authors.lastname: Liang
authors.forename: Hai Dong
authors.initials: HD
authors.lastname: Zhang
authors.forename: Shao Hua
authors.initials: SH
authors.lastname: Zhu
authors.forename: Tian Tong
authors.initials: TT
authors.lastname: Yang
authors.forename: Luo
authors.initials: L
authors.lastname: Zhuo
authors.forename: Gui Feng
authors.initials: GF
authors.lastname: Wang
authors.forename: Hong Xia
authors.initials: HX
authors.lastname: Liu
authors.forename: Liang
authors.initials: L
authors.lastname: Liu
mesh_terms: D001843:Bone Cements / Q000009:adverse effects*; D005260:Female; D049429:Forensic Pathology; D006801:Humans; D008875:Middle Aged; D019904:Polymethyl Methacrylate / Q000009:adverse effects*; D011654:Pulmonary Edema / Q000473:pathology; D011655:Pulmonary Embolism / Q000473:pathology*; D017550:Spectroscopy, Fourier Transform Infrared; D013123:Spinal Fusion / Q000009:adverse effects
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate